Physician-patient communication at the end of life: an investigation of the legal and socio-medical aspects of patient information, physician-patient communication and living wills.

This project consists out of a juridical part and a medico-sociological part.
 
1. THE JURIDICAL PART
The following aspects will be discussed:
 
A. The fundamental judicial principals in health-care such as:
- self-determination
- physicial integrity
- informed-consent
 
B. The physician-patient relationship:
- general practioner - patient
- attending physician - patient
Several elements of this/these relationship(s):
- the right to be informed
- the right to consent
- role of advance directives
The position of patients who are not capable to consent:
- minors
- psychiatric patients
- demented patients
The role of the representatives. How does he/she make a decision?
The role of the family.
 
C. Special attention goes to the end-of-life-decisions in all the different aspects mentioned above.
 
D. A comparitive study between the Belgian and Oregons rules.
 
 
2. THE MEDICO-SOCIOLOGICAL PART
Providing adequate care for terminal patients is getting more and more attention from society as well as science. There is increasing agreement that the quality of the last phase of life is an important additional aim of medical care.
Research has pointed out that physicians are frequently taking end-of-life decisions (ELD) but that this is not always done carefully. Patients are e.g. not always involved in these decisions (Deliens et al., 2000). A way to take the patients' opinion more into account and to improve the ethical-medical quality of ELD, is the use of a protocol or guidelines by physicians.
A second part of the project is about an end-of-life information and communication covenant: to what degree does it satisfy the wishes and needs of patients? What are practical modalities? What conditions should be met for a successful implementation?